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Women's health trigger > Female Sexual Disorders (Made by Billie) > Flashcards

Female Sexual Disorders (Made by Billie) Flashcards

1
Q

what are the four stages of sexual response

A
  1. Desire (libido) - intent to be sexually intimate
  2. Arousal - lubrication and swelling (vascular congestion) of genital tissue
  3. orgasm - release of tension, rhythmic contractions of reproductive organs & pelvic floow
  4. resolution - detumescence of genitalia & subjective sense of satisfaction
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2
Q

what has have excitatory hormonal effects

A
  • estrogen
  • testosterone
  • dopamine
  • NE
  • oxytocin
  • melanocortins
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3
Q

what has inhibitory hormonal effects

A
  • serotonin (high levels)
  • prolactin
  • opioids
  • endocannabinoids
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4
Q

During puberty, what things do variations of libido and sexual activity depend on?

A
  • mental health
  • relationship status
  • societal/cultural/family norms
  • phase of menstrual cycle
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5
Q

what is the primary goal in education for sex with puberty aged females

A

set healthy expectations for sexual activity

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6
Q

what is the biggest influence on sexual desire and satisfaction in perimenopausal or postmenopausal women? what other things may influence these

A

fluctuating hormones!!!

also insecurities about aging!

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7
Q

True or false: postmenopausal women alway shave decreased sexual desire/satisfaction

A

false!! some note increased sexual desire and satisfaction

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8
Q

what percentage of women experience some type of sexual dysfunction

A

43%

highest = SE asia
Lowest = europe

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9
Q

what is the MC stage of sexual response that causes dysfunction

A

Desire!

39% of US females

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10
Q

from MC to least common, list the areas of sexual dysfunction

A
  1. low sexual desire
  2. Low arousal response
  3. sex-related personal distress
  4. Orgasm Difficulties
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11
Q

what possible psychosocial issues can lead to sexual dysfunction

A
  • relationship factors
  • fatigue/stress
  • substance use
  • psychiatric disorders (including meds)
  • hx of abuse or negative experiences
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12
Q

what Gynecological conditions can lead to sexual dysfunction

A
  • pregnancy/childbirth
  • endometriosis
  • pelvic organ prolapse
  • GU syndrome of menopause
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13
Q

what chronic medical conditions can lead to sexual dysfunction

A
  • CVD
  • endocrine disease
  • neurologic disease
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14
Q

what is female sexual interest/arousal disorder

A

problems w low sexual desire or abdormal arousal response

emotional/mental or lubrication swelling

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15
Q

what is the criteria for diagnosis of female sexual interest/arousal

A
  1. must occur >75% of the time
  2. must occur for 6+ months
  3. must cause distress!!!
  4. Must include at least 3/6 from the following:
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16
Q

what is genitopelvic pain/penetration disorder

A

problems with either vaginismus, vulvar pain/vestibulodynia or dyspareunia

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17
Q

what is vaginismus

A

involuntary vaginal spasm

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18
Q

what is dyspareunia

A

pain w penetration or sexual activity

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19
Q

what is the criteria for genitopelvic pain/penetration disorder

A
  1. > 75% of the time
  2. 6+ months
  3. causes distress
  4. one or more of the following:
20
Q

what is commonly found in the hx of a patient with genitopelvic pain/penetration disorder

A

hx of sexual/physical trauma or abuse:(

21
Q

what is female orgasmic disorder

A

problems with frequency, intensity or achievement of orgasm response

22
Q

what is the criteria for female orgasmic disorder

A
  1. > 75% of the time
  2. 6+ months
  3. causes distress
  4. one of the following:
23
Q

what is substance/medication-induced sexual disorder

A

medication/substance related affect of desire, arousal, orgasm or any other parameter of normal sexual function

24
Q

what is the criteria for substance/medication-induced sexual disorder

A
  1. significant disturbance in sexual function
  2. disturbance occurred during or soon after exposure to medication/substance
  3. absence of other s/s that would better explain the dysfunction
25
Q

what is the leading culprit for substance/medication induced sexual disorder

A

psychiatric medications

26
Q

general overview of psychiatric medications effects on sexual function

A
27
Q

which antidepressents are related to sexual dysfunction

A
  • SSRIs
  • TCAs

SNRIs are NOT associated

28
Q

which anxiolytics are and are not associated with sexual dysfunction

A
  • BZDs are
  • buspirone is not
29
Q

what effect do anticonvulsants have on sexual function

A

decreased libido

30
Q

aside from psychiatric medications, what other medications can negatively affect sexual function

A
  • anticholinergics (antihistamines/antispasmodics)
  • antihypertensives (BB, clonidine, methyldopa)
  • hormonal agents
31
Q

what substances of abuse can impact sexual function

A
  • nicotine - limits sexual arousal
  • alcohol - hypogonadotropic state; impaired overall fxn
  • opiates - hypogonadotropic state; impaired overall fxn
  • marijuana - does not harm function but overall negative impact on
32
Q

how can infertility impact sexual function

A

sex may become a chore associated with disapointment:(

33
Q

what four body systems are associated with sexual function

A

neurologic, vascular, urinary and endocrine

34
Q

When is estrogen rx helpful in sexual disorders

A
  • menopausal VVA
  • improves libido, arousal response, pain secondary to vaginal atrophy
  • improves clitoral sensitivity
35
Q

what are SE of estrogen

A
  • liver disease
  • endometrial hyperplasia and cancer
  • VTE events
36
Q

what medication is approved for premenopausal patients with low sexual desire/libido

A
  • flibanserin (addyi)
  • bremelanotide
37
Q

what is the MOA of flibanserin (Addyi)

A

5HT-1a agonist/ 5HT-2a antagonist

causes decrease in 5HT and increase in NE/dopamine in regions of brain

38
Q

what are the SE of flibanserin

A

hypotension, dizziness, fainting

SE worse w alcohol. can also see nausea, fatigue, sleepiness or insomnia

39
Q

what are CI to flibanserin

A
  • alcohol
  • hypotension
40
Q

what is the MOA of bupropion

A

NE and dopamine reuptake inhibitor

41
Q

what tx has primary benefit seen in women w SSRI induced sexual dysfunction

A

PDE-5 inhibitors (off label)

sildenafil, tadalafil, vardenafil

42
Q

what is the MOA of bremelanotide (Vyleesi)

A
  • agonist on melanocortin receptors in the brain
43
Q

what are non pharmacologic treatment options for female orgasmic disorder

A
  • sexual devices
  • directed masturbation
  • genital cosmetic procedures
44
Q

what is GU syndrome of menopause

A

Pain secondary to hypoestrogenism and subsequent atrophy of GU tissues

45
Q

how do you treat GU syndrome of menopause

A

Women's health trigger (23 decks)

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